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The effect of CPAP on weight and fluid homeostasis will be assessed. Obstructive sleep apnea treatment-naive subjects will randomized to CPAP and control groups. Weight change, and changes in overnight urinary volume, intra and extracelullar volume, plasmatic B-type natriuretic peptide (BNP) and antidiuretic hormone (ADH) and urinary osmolality will be compared between groups.
There is a bidirectional relationship between Obstructive Sleep Apnea (OSA) and obesity. Although obesity can lead to OSA, patients with OSA are more likely to gain weight. The mechanisms that lead to weight gain during the treatment of OSA are not known. Some evidence supports the hypothesis that fluid accumulation could be a possible explanation for weight gain after treatment for OSA. The hypothesis is that one night of CPAP treatment promotes increased body weight and reduced diuresis in patients with OSA. Participants will be submitted to 2 consecutive nights of polysomnography (PSG). A baseline PSG will be performed during the first study visit. During the second study night, participants will be randomized into two groups, CPAP and control (repeat baseline PSG). Overnight urinary volume will be determined. Intra and extracellular water volume will be assessed using electrical bioimpedance before bedtime and just after the subject wakes up. Plasmatic BNP and ADH and urinary osmolality will also be determined during each morning following PSG.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | During the first and second study nights, subjects will undergo baseline polysomnography. | |
| Continuous Positive Airway Pressure | Experimental | Baseline polysomnography will be perfomed during the first study night and CPAP titration polysomnography will be performed during the second study night. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Continuous Positive Airway Pressure | Device | Continuous Positive Airway Pressure will be used during the second night of polysomnography . |
|
| Measure | Description | Time Frame |
|---|---|---|
| Weight change | Weight change with just one night of CPAP treatment. | After 6 hours of Continuous Positive Airway Pressure treatment |
| Diuresis change | diuresis change with just one night of CPAP treatment. | After 6 hours of Continuous Positive Airway Pressure treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Urinary osmolarity | Urine will be collected | After 10 hours of the nocturnal polysomnography |
| Atrial natriuretic peptide and antidiuretic hormone | Blood samples will be collected |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Pedro R Genta, MD.PhD | Sleep Laboratoy, Heart Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sleep Laboratory, Heart Institute, Pulmonary Division, Hospital das ClÃnicas da Universidade de São Paulo | São Paulo | 55 | Brazil |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41025888 | Derived | Lima GF, Herculano S, Fernandes MD, Lima-Junior JGA, Alves RSC, Drager LF, Lorenzi-Filho G, Genta PR. Acute effect of continuous positive airway pressure on weight in patients with obstructive sleep apnea: a randomized study. Ann Am Thorac Soc. 2026 Mar 1;23(3):429-437. doi: 10.1513/AnnalsATS.202505-491OC. |
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| ID | Term |
|---|---|
| D020181 | Sleep Apnea, Obstructive |
| D015430 | Weight Gain |
| ID | Term |
|---|---|
| D012891 | Sleep Apnea Syndromes |
| D001049 | Apnea |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D045422 | Continuous Positive Airway Pressure |
| ID | Term |
|---|---|
| D011175 | Positive-Pressure Respiration |
| D012121 | Respiration, Artificial |
| D058109 | Airway Management |
| D013812 | Therapeutics |
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| After 10 hours of the nocturnal polysomnography |
| Intra and extracellular fluid volume | Intra and extracellular fluid volume accumulation will be assessed by bioelectrical impedance | Before the beginning and after 10 hours of the nocturnal polysomnography. |
| D020919 |
| Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
| D001836 | Body Weight Changes |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012138 |
| Respiratory Therapy |